Lupus
Lupus is defined in Taber's Cyclopedic Medical Dictionary as 'originally any chronic, progressive, usually ulcerating, skin disease. In current usage when the word is used alone, it has no precise meaning' (Taber, 1273). This definition tends to underscore the enigma that is lupus, especially considering the simple definition provides eight different forms of lupus following it. When the term 'lupus' is used on House, it is almost always referring to systemic lupus erythematosus, or SLE. This disease with acute episodes that is characterized as a chronic autoimmune disease that involves multiple organ systems. Etiology Lupus is an autoimmune disease, or a disease in which the activation of self-antigens, specifically the T helper and B cells, causes the production of autoantibodies which attack the body's own cells. After a period of time, these autoantibodies and self-antigens react with each other enough to form large complexes that cannot be excreted, therefore gathering within the blood vessels and causing inflammation and blockages. The glomeruli, which are found in the Bowman's capsule of the kidney, are very much affected by these blockages. Autoantibodies may also encourage the destruction of cells by stimulating phagocytic activities. Diagnosis The American College of Rheumatology (ACR) created a list of eleven criteria for lupus. In order for a diagnosis to be made, the patient must have four or more of the following symptoms: # 'butterfly' rash # scaly, discolored skin lesions # antinuclear antibodies, or antibodies that are found more commonly in autoimmune diseases # immunological disorders including autoantibodies # pleuritis (inflammation of the lining surrounding the lungs) or pericarditis (inflammation of the sac surrounding the heart) # haemolytic anemia, leukopaenia, lymphopaenia or thrombocytopaenia, all which refer to the counts of certain cells within the blood # oral or nasopharyngeal ulcers # non-erosive arthritis # psychosis without a clear cause # photosensitivity skin rash # proteinuria greater than 0.5 grams per day (the normal value being 30 milli''grams per day) or cellular casts in the urine Some drugs may cause a lupus-like syndrome called drug-induced systemic lupus erythematosus. This condition usually disappears when the use of the drug is suspended. Symptoms As mentioned in ''House, the symptoms of lupus are very diverse. The most common symptoms include anemia, thrombopaenia (low platelet count), arthritis, fever, malaise, rashes, glomerulonephritis (inflammation of the glomeruli and kidneys), weight loss and low levels of complement (a protein in the blood that aids immunity). Most of the other symptoms can be explained by inflammation of the blood vessels and connective tissue. Treatment There is no cure for lupus. About 25% of patients have very mild SLE with only minor skin and haematological signs. These patients can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) and antimalarial medications. More severe cases must be treated with chemotherapy and corticosteroids along with calcium to prevent osteoporosis from steroid usage. Immunosuppressive drugs can be used during acute flare-ups or for long term suppression of the disease. Prognosis The prognosis for SLE depends on the organ systems involved along with the extent of damage and the speed at which the disease progresses. Most patients, at least 80%, survive to the ten-year mark, and most of the 20% of deaths can be blamed on renal failure and infections. Category:Diseases